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17845 POST THIS CARD NEAR FRONT OF BUILDING PENEW NUMBER CITY OF CUPERTINO 17845 INSPECTION DIVISION JOB INSPECTION RECORD J B•ADDRESS , • __(� Cf 0 L {T UNIT# _LOT# I1/`EUTTEXP MIRA TION I y� PERMIT EXPIRES IF WORK OWNER CONTRACTOR IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPECTION RECORD 160 DAYS OF PERMIT ISSU- ANCE OR 180 DAYS FROM FOUNDATION q— NOTE: LAST CALLED INSPECTION. UFER ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF PERMIT VALIDATION P R EG U N I7E CUPERTINO STANDARDS. GARAGE SLABSA 15 POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED J UNDERGROUND /SLAB OP A N �;. jA vC !_ f PLUMBING V ELECTRICALISSUANCE DATE HLUR ELECT PLG. MECH MECHANICAL ElEJ 0 00 NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION WOOD FLOOR VALUAl $/FT. PLUMBING MECHANICAL ' ELECTRICALCE ��LTT�t1l j FRAMING '" � S10RI15 TVPL CONST H. INSULATION DEC GROUP RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SU I T FLUUH/RILA TOTAL nLHCAGE ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE DIAPHRAGM THE CONSTRUCTION TAX IS PAID BuuulNc use / ROOF SHEATHING RLs IND CON PB O'l— /J APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. ❑ ❑ ❑ ❑ ❑ ASSESSORS PARCEL NO ROUGH SAN.N _� PLUMBING ELECT.ENERGY IHACI NO PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY MECHANICAL MECH.ENERGY ACC DATE ACC FILE NO ELECTRICAL BUILDING ENERGY I , FRAMING Jr— ¢N 7(*C ELECT.FINAL TEST ZONING ENG SITE NO, INSULATION PLUMBING GAS TEST GAS FIRESYNINK ENERGY L24 MECHANICAL v ❑ N❑ V ❑ N❑ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING 'LOOT ZONE AL UC. EXTERIOR SHEAR ELECTRICAL RELEASE INTERIOR SHEAR FIRE DEPT. r[_3 N❑ L N[_]r SHEETROCK GRADE FEESUMMARY EXTERIOR LATH BUILDING 'BUILDING W U INTERIOR LATH TEMPORARYAPPROVALS PLAN CHECK SCRATCH COAT ELECTRIC FEE Q� GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY SEISMIC FEE 9 OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUI LDING FINAL I SS IGNEDBY BU I LD I NG I NSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC 1U ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING SO PLEASE GIVE JOB ADDRESS WHEN PHONING. � — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! CONST. rnx PLEASE READ REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. \ f OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN 43ED LINES - USE BALL POINT PEN ONLY BU LDI NG PROJECT I DENTI FICATI ON PERMIT NUMBER 'BUILDING APPLICATION & PERMIT P- DDRE3S �y il (1 �._1 BUILDING - ELECTRICAL-PLUMBING-MECHANICAL Pd V V ER'S PLAN CHECK VALIDATION E �aA QTY. ELECTRIC PERMIT FEE qn PHONE C185-7100 NAme�CTOR'S - OUTLETS-SWITCHES-RECEP 10.00I7.00 h LIGHTING FIXTURES 10.00/1.00 [ uc.uo. ADDRESSTDRs APPLIANCES-RESIDENTIAL 4.00 ADDRESS PHONE PANELS 10.00 DATE OF APPLICATION ARCRRECTPANELS (OVER 200 AMP) 20.00 PLAN CHECK FEE P.C.NO. DR ENGINEER uc.NO. SIGNS TRANS. 3.00 ARCH.OR ENG. SPECIAL CIRCUIT S.00 PERMIT VALIDATION ADDRESS ZIP EMP.METER OR POLE INS. 20.00 APPucarvrs MOTORS SEE FEE SCH. ! ( V ADDRESS SERVICE CHANGE p 20.00 00 o LICENSED CONTRACTORS DECLARATION PAID m LUi I 1 hereby affirm that I am licensed under provisions of Chapter 9 ISSUANCE DATE (� - ¢ zU (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH. iProfessions Code,and my limnse is in full force and clTect. z20 w - License Class _ Us,Number LD z r w Date _ Contractor ra xCil of Cupertino BUILDING PERMIT rc Ic w ¢ OWNER-BUILDER DECLARATION INFORMATION E: 0 a, MISC.- REFER TO ORD w3 h I hereby affirm that I um exempt Gore the Contractor's License ._ o j Law for the following reason.(Sec 7031.5,Businessland Professions PERMIT ISSUANCE 10.00 VALUATION $/FT. E - Code:Any city or county which requires a permit to constn et,alteq D D D R2 Q 0 improve,connubial,or repair any structure,prior to its issuance,also ELEC.CONTE. LIC.NO. ELEC. 1�1� ou - O u- he moss the applicant for such rovisid to file t a signed actor's i that TOTAL PE l TO 1 K " he is licensed pursuant to the provisions of the Contractor's License za Law(Chand PoirosionsCde)ng or Section is 00)exemfD thereu3 and �� tile Business and Professions Code)ort n lie i is exempt therefrom and QTV. PLUMBING PERMIT FEE ¢ p the basis for the alleged a exemption.Any violation t toa cion malty STORIES TYPE CONSTR. n ; w by any applicant fora permit subjects the applicantmacivil penalty ALTER-DRAIN&VENT-WATER (EA.) 5.00 - of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS licir sole co npensatlnn,will do the work,and the structure is not ibudded or offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AR EA,COND. 5.00 Code:The Contractor's License Law does not apply to an owner of Property who builds or improves thereon,and who docs such work FIXTURES-PER TRAP 5.00 SO,FT.FLOOR AREA TOTALACREAGE himself or through his own employees,provided that such improve GAS-EA.SYSTEM-11NC.40UTLETS 6.00 ments are not intended or offered for sale.If,however,the budding or improvement is sold within one year of completion, the owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE ti builder will have the burden of proving thal Ire did not build or ire- RES IND CON PB Other _ prove for purpose ol'sale). INDUSTRIAL WASTE INTER. 30.00 V 1,as owner of the property,and exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sec.7044,Business LAWN SPRINKLERS- 1 INC 5 V.B. 6.00 ASSESSORS PARCEL NO. / and Professions Code.The Contractor's License Law does not apply to an owner o1property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contracton s)licensed pursuant to the Contractor's License Law, SEWER-SANITARY-STORM EA.200ft/10.00 TRACT NO. PARCEL NO. ❑ I and exempt under She.-,BARC.for this WATER HEATER W/VENT 6.00 reason Ownc Uate `j- WATER SYSTEM 5.00 ACC.GATE ACG FILE NO. w0 S'COMPENSATION UBCLARAT'ION WATER TREATING EQUIP. 5.00 I rereby affirm that 1 have a cenil icate of content to sc11-insum, ZONING ENG.SITE NO. or ertiffude of Workers'Cam Pensotion Insurance,(it a retitled copy thereof(Sec.3800,Lab.0). Policy No. Company ❑ Certified copy is hereby lurnishcd. FIRE SPRINK ENERGY T 24 Z 2 ❑ Certified copy is Bled with the city inspection division. MISC.- REFER TO ORD. y ❑ N❑ y ❑ N❑ O Applicant N CFR'I'IFICATIi OI'FX17MPTION FROM WORKERS' PERMIT ISSUANCE 10.00 FLOOD ZONE A.L.U.C. UJ > COhIPENSATION INSURANC17 PLG.CONTE. LIC.NO. PLG. V❑ N❑ v E] N❑ CL O (This section need not be completed it the permit is for one TOTAL Z hundred dollars($100)or less.) U O 1 certify that in the performance of the work for which this per- QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL H mit is issued,I ,shall not employ any person in any rammer so as to Ow become subject tothe Workers'ConnpensationLaws ofCalil'ornia, BUILDING Date Applicant ALTER OR ADD TO MECH. 5.00 } tail NOTICE,'f0 APPLICANT: IC after ndaking this Certificate of Ex- ? cndption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE U wrchov prisions or dills permit shall be dm eeed revoked. AIR HANDLING UNIT(TO 10=CF.M.) 4.00 p CONSTRUC'T'ION LENDING AGENCY AIR HANDLING UNIT(OVER 10 F.M. 6.00 SEISMIC FEE 3 1 hereby Abort that there is a construction lending agency for EXHAUST HOOD (WITH DUC 5. the Entorrhance of the work for which this permit is issued(Sec. HEATING UNIT(TO 100,000 T.U.) 8.00 MICROFILM 3097,Civ.C.). Lender's Name HEATING UNIT(OV ER 100,000 B.T.U.)9.50 ELECTRIC Lender's Address 1 certify that I have read this application and state that the above VENTILATION FAN (SINGLE) 4.00 Information is correct, I agree to comply with all city and cowdly BOILER-COMP(3'H.P,or 100,000 B.T.U.) 6.00 PLUMBING ordinances and state Taws Relating to building cOnstouc Hon, and hereby autldorDs representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL above-mentlonod property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. uperlino against liabilities,judgmen costs and expenses,which CONST.TAX may in any ay accrue against S ' Ci in consequence of the PERMIT ISSUANCE 10.00 s pcnmht. MECH.CONT. LIC.NO. MECH. TorAL TOTAL /3 / icant/Contractor to OFFICE COPY